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Post-burn scarring is often cosmetically unappealing and create discomfort. This makes it crucial to understand the experience of individuals living with scars which can offer insights into their recovery. This review sought to develop an in-depth understanding of living with post-burn scars.A systematic review and meta-ethnography approach were employed. We utilized an interpretive approach to inductively generate codes. These codes were examined iteratively using a constant comparison strategy following which they were re-interpreted to formulate themes which formed the basis of undertaking a narrative synthesis.Twenty-five studies were retained. The analytical process yielded two themes: emergence of a new identity and living with the redefined self. The experience of living with scars is entwined with the initial trauma as the scars served as a permanent reminder of the injury. Emergence of a new identity involved a process of meaning making, mourning the loss of the old self, confronting the new self, reconciling the remains of the old self with the new, rebuilding a new identity, and navigating through functional restrictions. These processes were particularly challenging for persons involved in self-immolation. Positive coping and changing one's perspective emerged as strategies to facilitate living with the redefined self.Living with scars is a challenging process which is more difficult for persons whose injuries are due to self-immolation (act of burning oneself). The findings highlight a latent yet ongoing process towards subjective recovery. Clinicians need to be aware of the processes and incorporate these into rehabilitation programmes.Burn survivors need ongoing professional support to adjust to and live with the scars. Victims of self-immolation should be considered for early psychosocial support.

Aims Despite the well-documented short-to-medium-term effectiveness of e-Health (electronic health) secondary prevention interventions on patients with cardiovascular disease (CVD), there is limited empirical evidence regarding long-term effectiveness. This review aims to evaluate the long-term effects of e-Health secondary prevention interventions on the health outcomes of patients with CVD. Methods and results This systematic review and meta-analysis followed Cochrane Handbook for Systematic Reviews of Interventions. EMBASE, Medline, Web of Science, and Scopus were searched from 1990 to May 2022. Randomized controlled trials investigating the effects of e-Health secondary prevention on health outcomes of CVD patients that collected endpoint data at ≥ 12 months were included. RevMan 5.3 was used for risk of bias assessment and meta-analysis. Ten trials with 1559 participants were included. Data pooling suggested that e-Health programmes have significantly reduced LDL cholesterol [n = 6; SMD = −0.26, 95% confidence interval (CI): (−0.38, −0.14), I2 = 17%, P < 0.001]; systolic blood pressure [n = 5; SMD = −0.46, 95% CI: (−0.84, −0.08), I2 = 90%, P = 0.02]; and re-hospitalization, reoccurrence, and mortality [risk ratio = 0.36, 95% CI: (0.17, 0.77), I2 = 0%, P = 0.009]. Effects on behavioural modification, physiological outcomes of body weight and blood glucose, and quality of life were inconclusive. Conclusion e-Health secondary prevention is effective in improving long-term management of risk factors and reducing the reoccurrence of cardiac events in patients with CVD. Results are inconclusive for behaviour modification and quality of life. Exploring, implementing, and strengthening strategies in e-Health secondary prevention programmes that focus on maintaining behaviour changes and enhancing psychosocial elements should be undertaken. Registration PROSPERO CRD42022300551.

Under investigation in this paper is the generalized AB system, which is extended from the well-known AB system that is used to describe the evolution of the wave packets in a marginally stable or unstable baroclinic shear flow. Introducing an auxiliary function $$\alpha (\tau )$$ , we construct the Nth-order vector solitary waves for the generalized AB system, which are different from the regular vector solitary waves in the existing literature. We find that the vector solitary waves are subject to spatiotemporal distortion (SD) effects in the evolution. Influenced by the SD effects, the vector solitary waves would evolve with the shape changes or the appearances, splits, combinations and disappearances of certain bulges. It is revealed that the SD effects do not change the interaction properties of the vector solitary waves. Excluding from the SD effects, we find that the interacting vector solitary waves not only exhibit the same local and global oscillations as the scalar solitary waves of AB system, but also lead to certain unique inelastic interactions as they possess different velocities. It is also found that two vector solitary waves with the same velocity may degenerate into a parallel-state solitary wave while two scalar solitary waves can not. For the interactions among the multi vector solitary waves, we observe that the symmetric parallel-state solitary waves interacting with standard bell-shaped solitary waves may bring about the destruction of the symmetric structures as well as the generation of the bound-state solitary waves, and that two symmetric parallel-state solitary waves interacting with each other may cause the broken symmetric structures for both ones. Moreover, the vector breathers and rogue waves of the generalized AB system are presented. Taking vector rogue waves in consideration, we demonstrate that the SD effects manifest themselves in two aspects: one is the destruction of the conventional one-peak-two-valley or four-petal symmetric structure; the other is the split of the rogue wave into some small ones with the adjustable number. Besides, modulation instability analysis presents the conditions under which the perturbed plane waves can develop into the distorted rogue waves.

A brief discussion with policy leaders and citizens was conducted to understand the unwillingness of people to get the COVID-19 vaccine and their suggestions to increase the vaccination level.Despite the crucial benefits of the COVID-19 vaccine, people are unwilling to get vaccinated. Vaccine hesitancy is a significant problem globally. In Palestine, at the time of this study only about 30% of the population were vaccinated.We used a descriptive qualitative design with semistructured interviews.The unwillingness of Palestinian people to get the COVID-19 vaccine was attributed to the spread of false rumours, misinformation, and conspiracy theories they received about the vaccine on the social media and mistrust towards vaccines the government purchased. There is a dire need to develop motivational strategies (i.e., incentives) and reconsider the media discourse and its unification to encourage people to get the vaccines. Social media and professionals should report the benefits/effectiveness of vaccination and avoid exaggerating its' side-effects.

A previous randomized controlled trial (NeCR) has indicated the effectiveness of nurse-led eHealth cardiac rehabilitation (CR) on modifying the behaviors of patients with coronary heart disease. However, limited qualitative studies explore the experiences of using eHealth CR that led to such benefits.The study aimed to explore the experiences of patients who participated in the NeCR program.A descriptive qualitative study was employed among 20 intervention group patients who used the eHealth CR website and ranked differently (0-35th percentile,35th percentile, and70% percentile) in the improvement of health-promoting behaviors.Five themes emerged: the NeCR program has promoted behavior change and mitigated emotional distress post-CHD. Patients described how the NeCR influenced cognitive determinants (knowledge and skill acquisition, having a roadmap, self-monitoring, and self-evaluation and resolution) and offered social support (professional counseling and peer interaction via multimedia chat) toward such change. Patients also appreciated the high affordability, accessibility, reliability of the NeCR, and expressed psychological, contextual, and technical barriers.Providing eHealth CR during patient discharge is warranted as an affordable, accessible, and reliable alternative to obtain health benefits. Extensive behavior change techniques, actionable CR guidance, and increased awareness are widely perceived enablers. Offering professional support and moderation is critical for early post-discharge consultation and for introducing direct peer interaction to reassure patients.

BACKGROUND Immersive virtual reality (IVR) applications are gaining popularity in health care education. They provide an uninterrupted, scaled environment capable of simulating the full magnitude of sensory stimuli present in busy health care settings and increase students’ competence and confidence by providing them with accessible and repeatable learning opportunities in a fail-safe environment. OBJECTIVE This systematic review aimed to evaluate the effects of IVR teaching on the learning outcomes and experiences of undergraduate health care students compared with other teaching methods. METHODS MEDLINE, Embase, PubMed, and Scopus were searched (last search on May 2022) for randomized controlled trials (RCTs) or quasi-experimental studies published in English between January 2000 and March 2022. The inclusion criteria were studies involving undergraduate students majoring in health care, IVR teaching, and evaluations of students’ learning outcomes and experiences. The methodological validity of the studies was examined using the Joanna Briggs Institute standard critical appraisal instruments for RCTs or quasi-experimental studies. The findings were synthesized without a meta-analysis using vote counting as the synthesis metric. A binomial test with P RESULTS A total of 17 articles from 16 studies totaling 1787 participants conducted between 2007 and 2021 were included. The undergraduate students in the studies majored in medicine, nursing, rehabilitation, pharmacy, biomedicine, radiography, audiology, or stomatology. The IVR teaching domains included procedural training (13/16, 81%), anatomical knowledge (2/16, 12%), and orientation to the operating room setting (1/16, 6%). The quality of the 75% (12/16) of RCT studies was poor, with unclear descriptions of randomization, allocation concealment, and outcome assessor blinding procedures. The overall risk of bias was relatively low in the 25% (4/16) of quasi-experimental studies. A vote count showed that 60% (9/15; 95% CI 16.3%-67.7%; P=.61) of the studies identified similar learning outcomes between IVR teaching and other teaching approaches regardless of teaching domains. The vote count showed that 62% (8/13) of the studies favored using IVR as a teaching medium. The results of the binomial test (95% CI 34.9%-90%; P=.59) did not show a statistically significant difference. Low-level evidence was identified based on the Grading of Recommendations Assessment, Development, and Evaluation tool. CONCLUSIONS This review found that undergraduate students had positive learning outcomes and experiences after engaging with IVR teaching, although the effects may be similar to those of other forms of virtual reality or conventional teaching methods. Given the identification of risk of bias and low level of the overall evidence, more studies with a larger sample size and robust study design are required to evaluate the effects of IVR teaching. CLINICALTRIAL International prospective register of systematic reviews (PROSPERO) CRD42022313706; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=313706

In this paper, a ([Formula: see text])-dimensional generalized breaking soliton system, for the interactions of the Riemann wave with a long wave, is investigated. Via the Hirota method, bilinear forms different from those in the existing literatures are derived. [Formula: see text]-soliton solutions are constructed via the Wronskian technique. Solitons with the crest curves being curvilineal are constructed, whose shape changes with the propagation. Parallel solitons have been obtained. Directions of the soliton propagation change, and speeds of the solitons are different: The higher the amplitude of the soliton is, the faster the soliton propagates. Breathers are constructed. Solutions consisting of a lump and two solitons are derived: Two solitons propagate in the same direction and the lump occurs in the region of the interaction between the two solitons.

International guidelines have promoted palliative care (PC) for stroke survivors, but definition and implementation have been less than ideal. This practice gap is more prominent in China, where discussion of death remains taboo.The aim of this study was to explore the perspectives of PC among caregivers of hospitalized patients with stroke.A descriptive qualitative study design was used. Seventeen in-depth interviews with bedside caregivers in a first-rank tertiary hospital (general hospital with bed capacity exceeding 500) in China were analyzed thematically."Promoting comfort" stands at the core of PC and was operationalized by "meeting physical care needs," "ensuring communication," "providing psychoemotional care," "providing cognitive stimulation," and "avoiding discussion on death and dying." Caregivers who took care of older adults for a long time have described the use of "cognitive stimulation" to promote patients' positive emotional and cognitive reactions. All interviewees avoided mentioning "death" to protect patients' feelings, because they believed discussion of death was hurtful.The high care demand for patients with stroke is a defining feature of stroke PC and should be recognized in addition to its prognosis estimation to promote this concept. The healthcare system should integrate PC as part of the regular service for patients with severe stroke to shift the focus of care from survival to promotion of comfort. A discussion of the dying process requires sensitivity and should be approached in a discussion of advanced PC planning, which views death as a meaningful transition.

Investigated in this paper is the AB system, which is used to describe the baroclinic instability processes in the geophysical flows. By introducing an auxiliary function α ( τ ) , we construct the...

To evaluate the current evidence that examined the effects of nurses' work environment interventions on nurse, patient, and hospital outcomes; and the key intervention characteristics.Quantitative systematic review without meta-analysis.Nine databases (British Nursing Index, CINAHL, EMBASE, Global Health, Global Health Archives, MEDLINE, Ovid Nursing, PubMed, and Web of Science) were searched following Systematic review Without Meta-analysis guideline to elicit studies that examined effects of interventions aimed at improving nurses' work environments among peer-reviewed publications from inception to April 2019.Database search used the following keywords: nurs*, patient, hospital, healthcare intervention, organizational improvement, nurs*adj4 outcome, patient adj4 outcome*, hospital adj4 outcome*, and their MeSH terms. The Cochrane's Risk of Bias in Non-Randomized Studies of Intervention (ROBINS-I) was used for quality appraisal. Donabedian model of Quality of Care was used as the framework to categorize interventions components focusing on structure and process aspects of the nurse work environments.The interventions included the use of accreditation process, educational strategies, and participatory approach. By defining the interventions which demonstrated positive effects on the nurse, patient, and hospital outcomes as effective, it appears that they are more consistently characterized as focusing on process improvement, adopting participatory approach, with greater involvement of frontline and nurse executives and at unit-level implementation.Although the heterogeneity in the design of the review studies precludes making conclusive insights on the best evidence to improve nurses' work environments, the review informs the major research gaps in the topic area and the ways to design better interventions to enhance the outcomes.The study provides insights on intervention components and strategies that can contribute to healthy nurse work environments. By adapting unit-level process improvements that actively involve frontline and nurse executives, nurse leaders may provide a more directed approach towards achieving favourable outcomes.目的: 评估护士工作环境干预措施影响护士、患者和医院结果的现有证据；以及主要的干预特征。 设计: 无荟萃分析的定量系统评估。 数据源: 根据无荟萃分析的系统评估指南，检索了九个数据库，即英国护理索引（British Nursing Index）、CINAHL、EMBASE、全球健康（Global Health）、全球健康档案（Global Health Archieves）、MEDLINE、奥维德护理（Ovid Nursing），PubMed和科学网（Web of Science），旨在从一开始到2019年4月在同行评审的出版物中研究旨在改善护士工作环境的干预措施的效果。 方法: 数据库搜索使用以下关键字：护理（nurs*）、患者（patient）、医院（hospital）、医疗保健干预（healthcare intervention）、组织改善（organization improvement），护理结果（nurs * adj4 outcome）、患者结果（patient adj4 outcome*）、医院结果（hospital adj4 outcome*）及其MeSH术语。科克伦（Cochrane）的非随机干预研究偏倚风险评估工具（ROBINS-I）用于质量评估。以多纳贝德“护理质量”模型为框架，对关注护士工作环境的结构和过程方面的干预因素进行分类。 结果: 干预措施包括使用认证程序、教育策略和参与式方法。通过将对护士、患者和医院结果产生积极影响的干预措施定义为有效的干预措施，这些干预措施的特点似乎更加一致：注重流程改进、采用参与式方法、一线护士和护士主管以及单位级别的更多参与。 结论: 尽管回顾性研究设计的异质性使得无法对改善护士工作环境的最佳证据做出结论性的见解，但该综述揭示了主题领域的主要研究差距以及设计更好的干预措施以提高结果的方法。 影响: 该研究提供了有关改善护士工作环境的干预措施和策略的见解。通过调整单位级流程改进，让一线护士和护士主管积极参与，护士领导可以提供更有针对性的方法来实现理想的结果。.

To evaluate the effects of eHealth cardiac rehabilitation (CR) on health outcomes of coronary heart disease patients and to identify programme design, which may lead to more effective health benefits.A systematic review and meta-analysis following Cochrane Handbook for Systematic Reviews of Interventions.Medline, EMBASE, CLNAHL, Web of Science, Scopus, PsycINFO, Cochrane Central Register of Controlled Trails, PubMed and CNKI were searched over the period from 1806 to April 2019.A systematic review and meta-analysis of randomized controlled trials to examine the effect of eHealth CR on health outcomes of coronary heart disease patients. We used RevMan 5.3 for risk of bias assessment and meta-analysis and GRADE software for generating findings.In all, 14 trials with 1,783 participants were included. eHealth CR has significantly promoted duration of physical activity, daily steps, quality of life (QoL) and re-hospitalization. Using comparative analysis of programme design elements, including mode of delivery, intervention content, motivational strategies and social support, between the effective and ineffective eHealth CR, it was found that comprehensive empowerment strategies and follow-up care by tele-monitoring may be the crucial characteristics leading to more favourable treatment effect.eHealth CR is effective in engaging patients in active lifestyle, improving QoL and reducing re-hospitalization. Future research needs to test the effects of comprehensive CR programmes by incorporating empowerment strategies and tele-monitoring as active components.eHealth has been increasingly applied to increase accessibility and uptake of CR. Integrative evidence to indicate its effects on health outcomes is lacking. This review identified its positive effects on some behavioural, psychosocial and health service use outcomes. Together with insights about which programme design elements may positively shape the outcomes, this review informs the role and practice of cardiovascular nurses in promoting evidence-based eHealth CR.目的: 评价电子医疗心脏康复(CR)对冠心病患者健康结果的影响,并确定方案设计,以期带来更为有效的健康效益。 设计: 根据《干预措施系统评估科克兰手册》开展系统评估与荟萃分析。 数据来源: 通过Medline、EMBASE、CLNAHL、Web of Science、Scopus、PsycINFO、Cochrane 临床对照试验中心注册数据库、PubMed和中国知网数据库对1806年至2019年4月期间的文献进行检索。 评估方法: 针对随机对照试验展开系统评估与荟萃分析,以研究电子医疗心脏康复对冠心病患者健康结果的影响。我们采用RevMan 5.3进行偏倚风险评估以及荟萃分析,同时应用GRADE软件生成发现结果。 结果: 共纳入了14项试验,涉及1,783名受试者。电子医疗心脏康复可显著地提高体力活动时间、日常生活步数、生活质量(QoL)和再入院情况。通过对有效和无效电子医疗心脏康复之间的方案设计要素,包括释药行为、干预内容、激励策略和社会支持进行比较分析,结果发现综合授权策略以及远程监测的后续护理可能对产生更为有利的治疗效果起决定作用。 结论: 电子医疗心脏康复可有效促使患者积极运动,提高生活质量,降低再住院率。今后的研究需将增强能力战略和远程监测作为有效方式来测试综合心脏康复方案的效果。 影响: 电子医疗已不断应用于增加心脏康复的可及性和摄取量。尚无综合证据表明其对健康结果的影响。本次评估确定了其对某些行为、心理社会和卫生服务使用结果的积极影响。结合针对何种方案设计要素可能对结果产生积极影响的研究发现,本次评估说明了对心血管护士在促进循证电子医疗心脏康复方面的作用和实践。.

Investigated in this paper is the defocusing nonlinear Schrodinger (NLS) equation, which is used for describing the wave-packet dynamics in certain weakly nonlinear media. With the physics-informed neural networks (PINNs), we modify the corresponding loss function in the existing literature and obtain two types of dark solitons, type-I and type-II solitons. It is demonstrated that the modified loss function presents higher-precision wave-packet behaviors based on fewer initial and boundary data. Taking type-I solitons into consideration, we find that when only a small fraction of initial and boundary data are given, the prediction accuracy of the wave packets will be increased one or two orders of magnitude at least if the modification term of the loss function is introduced. Furthermore, for the inverse problem, the modified loss function provides a better estimate of the nonlinear coefficient of the NLS equation based on fewer observed data of the wave packets. For type-II solitons, we compare the required data and predicted results of the PINNs with those of the conventional time-splitting finite difference (TSFD) method and reveal that achieving the same precision of the wave-packet behavior, the PINNs with the modified loss functions require only one tenth of the amount of the initial and boundary data of the TSFD method. Besides, both unmodified and modified loss functions are exploited for predicting the behaviors of Gaussian wave packets, and it is observed that the predicted result of the modified loss function agrees with the high-precision solution of the time-splitting Fourier pseudospectral method, whereas the unmodified loss function fails.

This study aimed to explore the perspectives of policymakers and patients on breast cancer (BC) management in the Gaza Strip.A descriptive qualitative study design was employed using semi-structured in-depth interviews with 13 policymakers and focus group discussions with 19 BC patients. The four criteria presented by Lincoln and Guba were used to evaluate the validity and reliability. Data were analysed using conventional content analysis approach.Three categories were generated from the qualitative data analysis: (1) limited human resources in the BC management, (2) inadequate institutional level service provision in the BC management, and (3) a lack of policy level support for the BC management. The current health services provided to Gazan BC patients are either fragmented or partially unavailable. The roles and responsibilities at the policy, system and individual levels were ambiguous. Policymakers attributed the fragmented BC services to the shortage of qualified healthcare professionals, inadequate training programmes for the staff, and lack of coordination among health institutions. Some patients expressed an insufficient knowledge about cancer screening tests, while others ignored screening for cultural reasons.Gaza's BC services are fragmented and not well-organised and they have received inadequate attention at the leadership and governance levels. The government in the Gaza Strip should strengthen its leadership to upgrade and develop the policies and strategies necessary for proper BC management, including an improved information system and cooperation with national and international institutions to secure funding for developing BC services and ensure medication availability.

Two-layer fluid models are proposed to describe certain nonlinear phenomena in fluid mechanics, thermodynamics and medical sciences. For a generalized(3＋1)-dimensional Yu–Toda–Sasa–Fukuyama equation for the interfacial waves in a two-layer liquid, in which h 0 is the constant coefficient of the development term, h 1 is the constant coefficient of the dispersion term, h 2 and h 3 are the constant coefficients of the nonlinear terms, and h 4 is the constant coefficient of the linear term. Based on the Pfaffian technique and certain constraint on h 3 , we obtain the multi-breather solutions in terms of the Gramian. For the one-breather waves, amplitudes are proportional to h 1 h 2 , velocity components along the x and z directions for the characteristic lines are proportional to h 1 h 0 , and velocity component along the y direction for the characteristic line is proportional to h 1 h 4 3 h 0 2 , where x , y and z are the spatial coordinates and t is the temporal coordinate. Interaction between the two-breather waves implies that the two-breather waves can evolve periodically along two straight lines on the x - y and y - z planes, period for the two-breather waves with t is proportional to h 0 h 1 , period for the two-breather waves along the y direction is proportional to h 4 3 h 1 , while the two-breather waves are not periodic along the x and z directions. Amplitudes, velocities and widths of the two-breather waves keep unchanged after the interaction between the two-breather waves on the x - y and y - z planes, which means that the interaction is elastic. On the x - z plane, the two-breather waves appear as two parallel solitons at certain angles with the x and z axes.

AIM: To assess corneal endothelial cells and corneal thickness in congenital cataract patients, which contributes to studying the characteristics and mechanism of the disease.METHODS: From August 2014 to December 2018, 141 patients diagnosed with congenital cataract before surgery in our hospital were analyzed retrospectively. Their endothelial cell density(ECD), average size(AVE), standard deviation of size(SD), coefficient of variation(CV), Hexagonality(Hex)and central corneal thickness(CCT)were measured with non-contact specular microscope. The data were statistically analyzed using partial correlation analysis to detect the correlation among patients' ECD, AVE, SD, CV, Hex, CCT and age, and we conducted curve fitting with multiple stepwise regression. We compared male and female patients', bilateral and unilateral cataract's parameters above by covariance analysis.RESULTS: The correlation between patients' ECD, AVE, SD and age was significant, and the fitting curve was obtained with equation ECD=3957.33-306.62×ln(age)、AVE=178.77+27.39×ln(age)and SD=77.13×e0.013×age respectively. CV was significantly greater in female patients than that in male patients(P=0.044). SD and CV was significantly greater in right eyes of bilateral cataract than that in affected eyes(P=0.037, P=0.028 respectively)and healthy eyes(P=0.007, P=0.003 respectively)from unilateral cataract, Hex was significantly less in right eyes of bilateral cataract than that in affected eyes(P=0.006)and healthy eyes(P=0.009)from unilateral cataract, CCT was significantly greater in right eyes of bilateral cataract than that in healthy eyes(P=0.041)from unilateral cataract.CONCLUSION: Congenital cataract may affect corneal endothelial cells and corneal thickness, especially SD, CV, Hex and CCT. Patients' ECD, AVE and SD changes with age. Female patients may have greater CV than male patients.

Background: Compassion has long been advocated as a fundamental element in nursing practice and education. However, defining and translating compassion into caring practice by nursing students who are new to the clinical practice environment as part of their educational journey remain unclear. Objectives: The aim of this study was to explore how Chinese baccalaureate nursing students define and characterize compassionate care as they participate in their clinical practice. Methods: A descriptive qualitative study design was used involving a semi-structured in-depth interview method and qualitative content analysis. Twenty senior year baccalaureate nursing students were interviewed during their clinical practicum experience at four teaching hospitals. Ethical considerations: Permission to conduct the study was received from the Institutional Review Boards and the participating hospitals. Results: Baccalaureate nursing students defined and characterized compassionate care as a union of “empathy” related to a nurse’s desire to “alleviate patients’ suffering,” “address individualized care needs,” “use therapeutic communication,” and “promote mutual benefits with patients.” Students recognized that the “practice environment” was characterized by nurse leaders’ interpersonal relations, role modeling by nurses and workloads which influenced the practice of compassionate care by nursing personnel. Conclusion: Compassionate care is crucial for patients, nurses, and students in their professional development as well as the development of the nursing profession. In order to provide compassionate care, a positive practice environment promoted by hospital administrators is needed. This also includes having an adequate workforce of nurses who can role model compassionate care to students in their preceptor role while meeting the needs of their patients.

Under investigation in this paper is a quintic time-dependent coefficient derivative nonlinear Schrodinger equation for certain hydrodynamic wave packets or a medium with the negative refractive index. A gauge transformation is found to obtain the equivalent form of the equation. With respect to the wave envelope for the free water surface displacement or envelope of the electric field, Painleve integrable condition, different from that in the existing literature, is derived, with which the bilinear forms and N-soliton solutions are constructed. Asymptotic analysis illustrates that the interactions between the bright and bound solitons as well as between the bright solitons and Kuznetsov–Ma breathers are elastic with certain conditions, while some other interactions are inelastic under other conditions. Propagation paths and velocities for the solitons are both affected by the dispersion coefficient function when the relations among the coefficients are linear, or affected by the dispersion coefficient, self-steepening coefficient and cubic nonlinearity functions when the relations among the coefficients are nonlinear. Under different conditions, bell-shaped solitons can evolve into the bound solitons or Kuznetsov–Ma breathers, respectively. Interactions between the bright and parabolic (or hyperbolic) solitons are related to the dispersion coefficient, self-steepening coefficient and cubic nonlinearity functions. Compression effect on the propagation paths of the solitons, caused by the dispersion coefficient, is observed.

In this paper, we investigate a generalized AB system, which is used to describe certain baroclinic instability processes in the geophysical flows. For the two short waves and mean flow, we derive out the Darboux and generalized Darboux transformations, both relevant to the coefficient of the nonlinear term and coefficient related to the shear. When the coefficient of the nonlinear term is positive, with the generalized Darboux transformation, we present the algorithm to derive the N th-order ( N = 1 , 2 , … ) rogue wave solutions. The first- and second-order rogue wave solutions are shown, where our first-order rogue waves are different from those in the existing literatures. The two short waves and mean flow are related to the coefficient of the nonlinear term under certain conditions; the coefficient related to the shear has a linear effect on the mean flow while has no effect on the two short waves. The N th-order rogue wave solutions turn to be singular when the coefficient of the nonlinear term is negative.

To observe the effect of electroacupuncture (EA) at "Zusanli" (ST36) and "Feishu" (BL13) on the expression of autophagy related proteins in the lung tissue of rats with chronic obstructive pulmonary disease (COPD), so as to explore the mechanism of EA underlying improvement of COPD.Thirty male SD rats were randomly divided into normal, model and EA groups (Following modeling, the FVC, FEV0.1, FEV0.3, FEV0.1/FVC and FEV0.3/FVC levels were significantly decreased (EA at ST36 and BL13 can improve the lung function of COPD rats, which may be related to its effects in inhibiting the autophagy level and reducing the inflammation response in the lung.

BACKGROUND Oncolytic viruses (OVs) can specifically infect and kill tumor cells. Adeno-associated virus (AAV) is a widely-studied OV. This study aimed to construct a tumor-targeted recombinant AAV using genetic engineering technology. MATERIAL AND METHODS The transgene plasmid pAAV-HE1B19K-TE1A was constructed with 4 genes (hTERT, E1A, HKII, and E1B19K) and co-transfected with pAAV-RC and pHelper to tumor cells (HepG2, A549, BGC-803) and normal cells (HUVEC). rAAV was verified with fluorescence microscopy. Quantitative PCR (qPCR) assay was used to test the titer of rAAV in each cell line. Apoptosis was analyzed using qPCR and Western blot assay. MTT was used to detect the effect of rAAV on cell viability. RESULTS The pAAV-HE1B19K-TE1A transgene plasmid was successfully structured. pAAV-HE1B19K-TE1A was highly expressed in all tumor cells. The titers of pAAV-HE1B19K-TE1A in HepG2, A549, and BGC-803 were 7.4×10⁷, 1.4×10⁸, and 1.1×10⁸ gc/μl, respectively. pAAV-HE1B19K-TE1A significantly decreased cell viability of tumor cells compared to that in HUVEC (p

Compassion is a core value of the nursing profession which enables nurses to empathize with and help alleviate patient suffering. Literature increasingly reports a lack of compassion in patient care by students and junior nurses; empirical knowledge regarding experiences of compassionate care among nursing students remains understudied. Student experiences in the clinical setting may influence their development of compassion competencies. This study explored the experiences of baccalaureate nursing students in gaining competencies to deliver compassionate care during their clinical practice year. A descriptive qualitative study using semi-structured in-depth interviews was conducted. Thematic analysis was employed, generating six themes. The first three themes depict positive aspects of compassion development, including 'gaining patient acceptance,' 'motivation for professional growth,' and 'establishing an emotional bond with patients.' On the other hand, the other three themes capture the barriers to compassionate care, 'distrust,' 'fear of harm due to violence,' and 'heavy workload.' The positive and negative experiences shared by students indicate that hospital and nursing administrators need to foster a positive practice environment and nursing instructors should become role models to encourage compassionate care.